JOR Spine最新文献

The cartilaginous endplates (CEP) are key components of the intervertebral disc (IVD) necessary for sustaining the nutrition of the disc while distributing mechanical loads and preventing the disc from bulging into the adjacent vertebral body. The size, shape, and composition of the CEP are essential in maintaining its function, and degeneration of the CEP is considered a contributor to early IVD degeneration. In addition, the CEP is implicated in Modic changes, which are often associated with low back pain. This review aims to tackle the current knowledge of the CEP regarding its structure, composition, permeability, and mechanical role in a healthy disc, how they change with degeneration, and how they connect to IVD degeneration and low back pain. Additionally, the authors suggest a standardized naming convention regarding the CEP and bony endplate and suggest avoiding the term vertebral endplate. Currently, there is limited data on the CEP itself as reported data is often a combination of CEP and bony endplate, or the CEP is considered as articular cartilage. However, it is clear the CEP is a unique tissue type that differs from articular cartilage, bony endplate, and other IVD tissues. Thus, future research should investigate the CEP separately to fully understand its role in healthy and degenerated IVDs. Further, most IVD regeneration therapies in development failed to address, or even considered the CEP, despite its key role in nutrition and mechanical stability within the IVD. Thus, the CEP should be considered and potentially targeted for future sustainable treatments.

Lumbar intervertebral disc herniation, as a leading cause of low back pain, productivity loss, and disability, is a common musculoskeletal disorder that results in significant socioeconomic burdens. Despite extensive clinical and basic scientific research efforts, herniation etiopathogenesis, particularly its initiation and progression, is not well understood. Understanding herniation etiopathogenesis is essential for developing effective preventive measures and therapeutic interventions. Thus, this review seeks to provide a thorough overview of the advances in herniation-oriented research, with a discussion on ongoing challenges and potential future directions for clinical, translational, and basic scientific investigations to facilitate innovative interdisciplinary research aimed at understanding herniation etiopathogenesis. Specifically, risk factors for herniation are identified and summarized, including familial predisposition, obesity, diabetes mellitus, smoking tobacco, selected cardiovascular diseases, disc degeneration, and occupational risks. Basic scientific experimental and computational research that aims to understand the link between excessive mechanical load, catabolic tissue remodeling due to inflammation or insufficient nutrient supply, and herniation, are also reviewed. Potential future directions to address the current challenges in herniation-oriented research are explored by combining known progressive development in existing research techniques with ongoing technological advances. More research on the relationship between occupational risk factors and herniation, as well as the relationship between degeneration and herniation, is needed to develop preventive measures for working-age individuals. Notably, researchers should explore using or modifying existing degeneration animal models to study herniation etiopathogenesis, as such models may allow for a better understanding of how to prevent mild-to-moderately degenerated discs from herniating.

Biomarkers are commonly recognized as objective indicators of a medical state or clinical outcome and have been widely used as clinical and diagnostic tools and surrogate endpoints in many pathological conditions. In the context of intervertebral disc (IVD) and associated back pain, also known as degenerative disc disease (DDD), the use of biomarkers has been poorly explored. DDD is currently diagnosed using imaging techniques and subjective pain scales, limiting an objective association between DDD and pain levels, as well as an evaluation of disease progression. There is a need for objective and reliable measurements for DDD, pain and pathology progression. DDD predictors could also help clinicians in deciding on the optimal treatment for distinct patient groups. This review addresses the current candidate biomarkers in DDD, including imaging, genetic, metabolite and protein-based parameters, both at the tissue and systemic levels, that may become a major advance in the diagnosis and prognosis of the disease, as well as in the management of therapeutic approaches to DDD.

As the seasons begin to change (at least in the northern hemisphere), we turn our attention to gathering the fruits of our collective labor and start our planning for the coming year. Since the groundwork and planning began in earnest in the fall of 2017, to our first issue in March of 2018, to the present day, the ‘seeds’ that were the JOR Spine concept have come to fruition, and we can now all share in the bounty that is our JOR Spine journal. Over the last six years, the international spine community has come together to support this new effort, and we have steadily progressed though the benchmarks that signify stability and success of a new journal. Last summer we were delighted to receive our first impact factor, a major milestone. This past July, we were even more delighted to find out that our impact factor had held steady, at a 3.7. While impact factor is only one metric, we are happy that all of your labors, and excellent submissions, have had this result, and firmly establish the JOR Spine in the top echelon of Spine related journals.

As we think to the future, we are excited by plans for the coming year. The December issue is slated to be a ‘special issue’, with a compendium of manuscripts from the 2022 ORS/PSRS meeting. We thank the organizers for that great meeting and for assembling an outstanding lineup of papers that are being finalized. Many of you also just finished a race to the finish line for your ORS 2024 abstract submissions. We are excited to see all of the new spine-focused work presented at the meeting, and to see it submitted to the JOR Spine soon! We also look forward to celebrating with all of you our next JOR Spine Early Career Awardee. As you'll recall from past years, this award, developed in collaboration with the ORS Spine Section, is designed to recognize the ‘rising stars’ of our field and highlight their outstanding work published in the JOR Spine. For each of the past four years, awardees have been recognized at the ORS Annual Meeting, and we look forward to continuing this tradition in the coming year. Applications for this highly competitive award are due October 30th, 2023 and information on the award nomination process and eligibility criteria can be found at: https://onlinelibrary.wiley.com/page/journal/25721143/homepage/earlycareeraward. Please consider nominating your colleagues (or yourself) for this Award!

As we move into the fall, we wish you all a bountiful harvest, and look forward to your excellent submissions and suggestions, the seeds that will continue our progress in building JOR Spine into the preeminent spine journal for our community.

Rob, Mauro, and Dai.